Jan. 19, 2012 -- Most states are doing an "abysmal" job in actions to protect children from cigarette
smoking, and some are cutting funds for tobacco cessation programs because of stagnant economic conditions that are reducing revenues, the American Lung Association says in a new report.

The ALA's State of Tobacco Control 2012 report card monitors progress on tobacco control policies at the federal and state levels and assigns grades that measure how laws are protecting people.

State report cards for 2011 were full of F's, and A's in any category were scarce, Erika Sward, director of national advocacy for the American Lung Association, tells WebMD.

43 States Flunk at Tobacco Prevention

Forty-three states plus Washington, D.C., earned grades of F for failing to fund tobacco prevention and control programs at needed levels. What's more, 32 states plus Washington, D.C., made grades of F for failing to offer comprehensive quit-smoking treatments to Medicaid recipients and for failing to invest enough on tobacco cessation programs for state employees.

Alabama, Mississippi, Missouri, South Carolina, Virginia, and West Virginia received grades of F on all categories analyzed. Only Delaware, Hawaii, Maine, and Oklahoma received all passing grades, and not a single state earned straight A's.

Tobacco Industry Spending More to Entice Youths

Youth and adult smoking rates have declined slowly over the past decade, but the decline has not been consistent and has stalled at times, according to the researchers.

Sward says tobacco companies, in a new technique to introduce people to their products, are selling smoke-free dissolvable products that contain nicotine in some states. These include toothpicks, breath mints, and strips "that melt in your mouth," she says.

She tells WebMD that the FDA is studying the products and could take action soon.

The ALA's president and CEO, Charles D. Connor, says in a news release that President Obama has "confronted the tobacco epidemic head-on," but in a teleconference adds that the federal government needs to do more.

The ALA's report says some states are retreating on programs that reduce childhood smoking. Connor says, "We know that most states aren't doing everything they should to help smokers quit, and as a result, millions of people won't get the help they need to stop smoking."

Three states -- Missouri, Connecticut, and Tennessee -- did expand quit-smoking coverage to all Medicaid enrollees, a positive step, the ALA says.

A Setback

Connor notes that the federal government made some strides last June when the FDA released nine graphic warning labels, requiring manufacturers to put the labels on cigarette packages by the fall of 2012.

But a federal court ordered the FDA to delay implementing its order. The ruling is under appeal.

The ALA says it "strongly supports" the graphic labels.

Still, the government earned an A for FDA regulation of tobacco products. It scored a C for coverage of tobacco cessation treatments under major federal health care programs, a D for the federal cigarette tax, and another D for signing but not ratifying an international treaty to control tobacco use.

Overall: 2011 a Bad Year

"With very few exceptions, 2011 was an abysmal year for tobacco control measures at the state level," the researchers write.

For instance, New Hampshire cut its cigarette tax by 10 cents per pack in 2011, even though it is known that higher costs reduce tobacco consumption, the ALA says.

"2011 was also the first year in recent memory where no state significantly raised its tobacco tax," the researchers report.